I went to the National Consumer Directed Healthcare Summit in DC yesterday skeptical but with an open mind. And after Paul Ginsburg’s opening talk, I was thinking there may well be a pony in here somewhere. Unfortunately, I left after three more presentations still searching for the pony.
I was at the Summit on a press pass, a result of a leap of faith by the Summit’s founders who were (wisely) concerned that my apparent bias against consumer directed health plans would make my review of the Summit a hatchet job. I thank them for their faith.
My general sense is there were two groups of people in attendance; the speakers on the first day (with some exceptions were) a Washington-focused group of thinktankers, Bush Administration folks and friends thereof. The other group included insurance companies, employers, labor, and entrepreneurs more interested in the business opportunity than the self-congratulatory bonhomie that was woven into the presentations.
Except for Paul Ginsburg’s. Dr. Ginsburg (an aquaintance) gave a brief talk on the role of benefit design on consumer behavior. His presentation noted that at present the fairly rigid definition of CDHPs (that is, what a CDHP is for tax purposes) is quite limiting, and will likely severely reduce CDHP’s usefulness. I may be pushing Paul’s point a little, but not much.
His main points were several.
1. there are no income-based deductibles, therefore the mandated deductible amount will be (relatively) high and therefore unaffordable for low-income folks and low for the wealthy and therefore have limited impact on their spending habits.
2. a lot of the spending in health care is for the chronically ill, a group that will blow thru their deductibles and then will have no incentive to be smart consumers.
3. the plans have weak incentives to use “good” providers and weak incentives to manage one’s own health.
CDHPs are at an early stage in their relatively brief life. But that life may be quite short if these serious shortcomings are not addressed, and fast. The presentations by the speakers following Paul were long on gloss, superficial statements, and outright errors of fact and short on recognizing the limitations of CDHP and suggestions for ways to address those limits.
Unfortunately they did a much better job of obscuring the pony than narrowing down the search.
More on that in the next post.
